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[肠易激综合征患者的预后。一项为期1年随访的前瞻性研究]

[Prognosis of patients with irritable intestine syndrome. A prospective study with 1 year follow-up].

作者信息

Linares Rodríguez A, Rodrigo Sáez L, Pérez Alvarez R, Sánchez Lombraña J L, Rodríguez Pérez A, Arribas Castrillo J M

机构信息

Hospital de Cabueñes, Gijón.

出版信息

Rev Esp Enferm Dig. 1990 Jan;77(1):18-23.

PMID:2334579
Abstract

An analysis was made of the prognosis over a one-year follow-up period of a consecutive series of 86 out patients with irritable bowel syndrome (SII) who were treated randomly with an antispasmodic (otilonium) or a tranquilizer (clobazam), and the existence of factors, mainly psychological, that could worsen it was determined with the Zung anxiety test and the Hamilton depression scale. We confirmed that irritable intestine syndrome is a chronic disease, with a mean course of 13 +/- 12.5 years at the time of consultation. A large proportion of patients had permanent problems (58.1%) and did not experience important changes in the intensity of symptoms throughout evolution (68.6%). Although most improved initially with the treatment instated (76.7%), the improvement was rarely complete (11.8%). A year after beginning treatment, 61.6% were the same or worse than before the index consultation. In the group of patients with a good course, the proportion of those that correctly followed medical treatment and of those who had experienced more or less lengthy asymptomatic periods before consultation was significantly larger. In the group of patients with poor evolution, the scores on the Zung anxiety test and Hamilton depression scale were significantly higher than in those who evolved favorably. Neither consultation of a specialist nor the treatment used in this study seem to have contributed to an evident improvement in the prognosis.

摘要

对86例肠易激综合征(IBS)门诊患者进行了为期一年的随访预后分析,这些患者被随机给予抗痉挛药物(奥替溴铵)或镇静剂(氯巴占)治疗,并通过zung焦虑测试和汉密尔顿抑郁量表确定主要是心理因素导致病情恶化的情况。我们证实肠易激综合征是一种慢性病,就诊时平均病程为13±12.5年。很大一部分患者存在永久性问题(58.1%),且在整个病程中症状强度未发生重大变化(68.6%)。虽然大多数患者最初接受治疗后有所改善(76.7%),但改善很少是完全的(11.8%)。开始治疗一年后,61.6%的患者与初次就诊前相同或病情更差。在病情良好的患者组中,正确遵循治疗的患者比例以及就诊前经历过或多或少较长无症状期的患者比例明显更高。在病情进展不佳的患者组中,zung焦虑测试和汉密尔顿抑郁量表的得分明显高于病情进展良好的患者。本研究中的专科会诊和所用治疗方法似乎均未对预后的明显改善起到作用。

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